Aloe ferox

Cape Aloe - Aloe ferox

Important medicinal plant. Bitter aloe. Large spikes of red-orange flowers, attracting many birds including sunbirds. Looks great as pot-plant. Full sun, sandy, well-drained soil, allow to dry between watering’s. Depicted in San rock art.

Cape Aloe is one of the best known South African plants for her medicinal uses and a common addition to cosmetics and tonic drinks. The leaf gel is moistening, cooling, soothing, cleansing, anti-inflammatory
and antimicrobial and therefore is applied topically for wounds, burns, eczema, abrasions and bruises.
The latex is strongly laxtive and it is not advised to be used without the guidance of a health practitioner.

Cape Aloe is endemic to SA. She has fleshy, succulent leaves with spines along the edges and lower surface. She flowers from May to August with bright red or orange candle-shaped flowers that attract many birds, especially sunbirds, and and insects as pollinators.

Plant Uses & Benefits: bees, birds, butterflies, cosmetics, food, medicine, pot plant, small garden, water-wise, wind tolerant

Names

Common names: Cape aloe, bitter aloe (English); umhlaba, ikhala (Xhosa); inhlaba (Zulu); bitteraalwyn, Kaapse aalwyn, bergaalwyn (Afrikaans). 
Botanical name: Aloe ferox

Family: Asphodelaceae

• Etymology – “ferox” means war-like or fierce, and refers to the spiny edged leaves
• Confusers – Other aloes


Nature

Type: succulent
Vegetation type:  
Flower colour: orange
Flowering season: Winter
Plant-animal interactions: bees, birds, butterflies
Red list status: Least Concern

Endemic to South Africa, Cape Aloe has a distribution that includes the Eastern Cape, Free State, KwaZulu-Natal and Western Cape. She has fleshy, succulent leaves with spines along the edges and lower surface. She flowers from from May to August, later if cold, with bright red or orange candle-shaped flowers. The flowers contain nectar, attracting many birds, especially sunbirds, and insects as pollinators.

Cape Aloe is widely distributed and cultivated. She is a popular garden plant that enjoys no conservation concerns.

Nature
Fleshy, succulent leaves with spines along edges and lower surface
Flowers bright red or orange candle-shaped from May to August, later if cold.
Flowers contain nectar, attracting birds, especially sunbirds, and insects as pollinators.12
Conservation Ecology
Widely distributed, cultivated and popular garden plants, no conservation concerns.
Aloe ferox leaves provide an insulating layer to protect against fires, and harvesting of leaves could result in significant mortality in fires.13
Plant Identification
Spines down back of leaves in the midline


Use as Medicine

Herbal traditions: British, Cape Dutch, Cape Herbal Medicine, Khoi & San
Plant parts used: leaf gel, leaf latex, leaves, roots

Cape Aloe is one of the best known South African plants for her medicinal uses for which the inner leaf juice/gel, bitter yellow latex from outer leaf and roots are used.

Cape Aloe is moistening, cooling, soothing, cleansing, protecting, (purging). She is wound healing, anti-inflammatory and antimicrobial. The latex is strongly laxative and it is not advised to be used without the guidance of a health practitioner.

Traditionally, the leaf gel or sliced leaf was applied topically for wounds, burns, eczema, abrasions, bruises. Orally, she was taken for stomach ache, poor appetite, colitis, constipation, arthritis, hypertension, stress. Modern use has not changed much aside from the fact she is now a common addition to cosmetics and tonic drinks.

Safety & Toxicity

Safety: allergic contact dermatitis, alter absorption of oral drugs, caution in long-term use

• Topical use no safety concerns
• Unprocessed Aloe contains aloin that has strong laxative properties – use of latex products should not be used for longer than 2 weeks.
• Due to laxative, purgative action of the latex, caution should be observed with all chronic medication.
• There are a few case reports of allergic contact dermatitis after using aloe gel.14

• A study in rats looking at liver and kidney function and haematological parameters, suggests that A. ferox may be safe as an oral remedy for constipation. Generally, the effect of the extract compared favourably with Senokot, a recommended drug for the treatment of constipation.
• A. ferox gel may alter absorption of oral drugs. This study identified a modulation effect of efflux transporters by certain aloe materials. This may cause herb-drug pharmacokinetic interactions when drugs that are substrates for these efflux transporters are taken simultaneously with aloe materials. On the other hand, these aloe materials may be used for drug absorption enhancement for drugs with low bioavailability due to extensive efflux.15,16
• In vitro genotoxicity study demonstrates that dried A ferox juice containing hydroxyanthracene derivatives does not induce DNA damage.17

Qualities & Phytochemistry

Plant qualities: 
Phytochemical constituents: alkaloids, aloctin A, aloctin B, aloeresin, aloesin, aloin, anthraquinone glycoside, flavonoids, flavonols, glucomannans, glycoproteins, mannans, phenols, polysaccharides, proanthocyanidins, saponins, tannins

Leaves18,19
Cooling, soothing, cleansing, protecting, purging, bitter (latex)
• Polysaccharides (mannans, glucomannans)
• Glycoproteins (Aloctin A & B)
• Aloesin, Aloeresin A – anti-inflammatory, skin lightening – inhibiting melanin synthesis due to anti-tyrosinase activity (latex).
• Aloin – anthraquinone glycoside that acts as stimulant laxative (latex).
• Phenols
• Flavonoids
• Flavonols
• Proanthocyanidins
• Tannins
• Alkaloids
• Saponins

Actions & Pharmacology

Plant actions: anthelmintic / vermifuge, anti-cancer, anti-inflammatory, anti-pruritic, antibacterial, antifungal, antioxidant, laxative, vulnerary

Vulnerary
• An in vitro study indicated that A. ferox has the ability to heal wounds to a larger extent and at a faster rate than the control (untreated keratinocytes). The gel exhibited faster wound healing action than the whole-leaf material.20
• Aloe ferox facilitates healing by temporarily creating a fibrin clot and granulation of elastin, collagen, proteoglycans and other connective tissue fibres by fibroblasts.21
• The gel has been shown to reduce wound diameter, decrease scarring, and reduce acute inflammation, collagenase and metalloproteases activity.21
• Aloe ferox increases blood supply to wounds, thereby increasing blood supply and facilitating rapid granulation.21
• A glycoprotein found in Aloe ferox stimulates the formation of epidermal tissue.21
Anti-inflammatory (gel)
• A study that compared gel extracts of Aloe vera and Aloe ferox in the topical treatment of mice with atopic dermatitis found that both species inhibited the cutaneous inflammatory response. A. ferox was superior to A. vera in reducing the serum IgE levels.22
• A. ferox displayed high COX-1 and COX-2 enzyme inhibition in vitro assay.23
• A. ferox gel has anti-erythema activity in humans similar to that of hydrocortisone gel after 6 days of treatment. This study also found that A. ferox has a dehydrating effect on the skin.20
Antimicrobial
• A study on A. ferox showed strong inhibitory activity against the Gram-positive bacteria that were investigated (Bacillus subtilis, Micrococcus kristinae and Staphylococcus aureus) as well as against multiple fungal species. The ethanol extract had a greater inhibitory effect than the water extract. Gram-negative E. coli and P. vulgaris were also inhibited by the ethanol extract.24
• A study on the wound healing effects of A. ferox whole-leaf juice preparation showed that it facilitated the healing process, selectively inhibited microbial growth, and had no adverse effects.25
• Study on A. ferox extracts assessed in vitro antimicrobial activity against six Gram-positive and seven Gram-negative bacterial strains and four fungi commonly associated with skin conditions. A. ferox found to be active against almost all of the tested bacterial and fungal strains.26
Antioxidant
• Study showed high level of radical scavenging activity by ethanol and methanol whole leaf extracts of A. ferox in various assays.18
• A. ferox leaf gel shows antioxidant capacity as confirmed by ORAC and FRAP analyses due to the presence of the antioxidant polyphenols, indoles, and alkaloids.19
Antipruritic
Laxative (latex)
• Study in rats with loperamide-induced constipation showed that an aqueous leaf extract of A. ferox increased intestinal motility, increased fecal volume and normalized body weight in the constipated rats, which are indications of laxative property of the herb with the 200 mg/kg body weight of the extract showing the best efficacy.27
Anthelmintic (latex)
• Multiple studies in livestock showing efficacy of A.ferox as anthelmintic.28–32
Anti-cancer
Other
• transdermal drug penetration enhancer.33
• Prebiotic
• Mucous membrane trophorestorative
• Purgative in high doses

Preparations

Plant preparations: compress, decoction, gel, infusion - aqueous, poultice, powder, resin, wash

• bitter yellow latex from outer leaf dried into black resinous solid (commercially known as ‘Cape Aloes’) – can be drained by cutting the leaves and placing them vertically, or boiling off the gel (smoke is toxic).

Preparations
• leaf gel
• powder
• infusion
• decoction
• wash
• compress
• poultice (resin – latex)

First-Aid Indications

First-aid use: abrasions, arthritis, boils, bruising, burns, constipation, eczema, insect bites, obesity, poor appetite, ringworm, sinusitis, stomach ache, stress, wounds 

Skin – applied topically
• wounds
• burns
• eczema21
• abrasions
• bruises
• insect bites21
• ringworm21
• boils21
Digestion – taken orally
• stomach-ache
• poor appetite
• colitis
• constipation
• weight loss34
Respiratory
• sinusitis
Musculoskeletal
• arthritis
Psychiatric
• stress

Medical Indications

Medical use:  

• Hypertension34
• Cancer35
• Conjunctivitis
• Diabetes34

Veterinary Indications

Medical use:  

• A study on gastrointestinal nematodes in sheep found A. ferox improved animal weight gain and suppressed the production of nematode eggs. 250g of dried, powdered leaves given daily to each lamb for 10 weeks resulted in the maximum reduction of eggs per gram and highest average daily gain.36
• Traditionally leaves are dried and powdered and given to chickens, turkeys, sheep, and goats as an anthelmintic.28–32

• A survey done in the Eastern Cape found that A. ferox is one of the plants traditionally used for the treatment of cattle wounds and myiasis. A leaf infusion is used as a wound wash, and the juice is applied as a wound dressing.37
• A study on the efficacy of ethnoveterinary remedies to control ticks in cattle and dogs found that A. ferox was not an effective acaricide.38,39 However, another study showed that high concentration A. ferox infusion soaps had a strong topical application toxicity against ticks.40
• Used for cleansing, and topically to foster hair growth, soften hair, and prevent hair loss.21

Dosage

Research

Review Articles
1. Nalimu F, Oloro J, Kahwa I, Ogwang PE. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Futur J Pharm Sci. 2021;7(1):145. doi: 10.1186/s43094-021-00296-2. Epub 2021 Jul 21. PMID: 34307697; PMCID: PMC8294304.
2. Salehi B, Albayrak S, Antolak H, Kręgiel D, Pawlikowska E, Sharifi-Rad M, Uprety Y, Tsouh Fokou PV, Yousef Z, Amiruddin Zakaria Z, Varoni EM, Sharopov F, Martins N, Iriti M, Sharifi-Rad J. Aloe Genus Plants: From Farm to Food Applications and Phytopharmacotherapy. Int J Mol Sci. 2018 Sep 19;19(9):2843. doi: 10.3390/ijms19092843. PMID: 30235891; PMCID: PMC6163315.
3. Radha MH, Laxmipriya NP. Evaluation of biological properties and clinical effectiveness of Aloe vera: A systematic review. J Tradit Complement Med. 2014 Dec 23;5(1):21-6. doi: 10.1016/j.jtcme.2014.10.006. PMID: 26151005; PMCID: PMC4488101.
4. Cock IE. The Genus Aloe: Phytochemistry and Therapeutic Uses Including Treatments for Gastrointestinal Conditions and Chronic Inflammation. Prog Drug Res. 2015;70:179-235. doi: 10.1007/978-3-0348-0927-6_6. PMID: 26462368.
5. Grace OM, Simmonds MS, Smith GF, van Wyk AE. Therapeutic uses of Aloe L. (Asphodelaceae) in southern Africa. J Ethnopharmacol. 2008 Oct 28;119(3):604-14. doi: 10.1016/j.jep.2008.07.002. Epub 2008 Jul 16. PMID: 18682283.
6. Mkwanazi MV, Ndlela SZ, Chimonyo M. Indigenous knowledge to mitigate the challenges of ticks in goats: A systematic review. Vet Anim Sci. 2021 Jul 4;13:100190. doi: 10.1016/j.vas.2021.100190. PMID: 34296043; PMCID: PMC8281653.
7. van Wyk BE. A broad review of commercially important southern African medicinal plants. J Ethnopharmacol. 2008 Oct 28;119(3):342-55. doi: 10.1016/j.jep.2008.05.029. Epub 2008 Jun 3. PMID: 18577439.
Clinical Research
Clinical Trials
Randomised Controlled Trials
1. Finberg MJ, Muntingh GL, van Rensburg CE. A comparison of the leaf gel extracts of Aloe ferox and Aloe vera in the topical treatment of atopic dermatitis in Balb/c mice. Inflammopharmacology. 2015 Dec;23(6):337-41. doi: 10.1007/s10787-015-0251-2. Epub 2015 Oct 28. PMID: 26510768.
2. Ahmed M, Laing MD, Nsahlai IV. In vivo effect of selected medicinal plants against gastrointestinal nematodes of sheep. Trop Anim Health Prod. 2014 Feb;46(2):411-7. doi: 10.1007/s11250-013-0506-0. Epub 2013 Nov 29. PMID: 24293151.

Meta-Analyses – none

Systematic Reviews
1. Mkwanazi MV, Ndlela SZ, Chimonyo M. Indigenous knowledge to mitigate the challenges of ticks in goats: A systematic review. Vet Anim Sci. 2021 Jul 4;13:100190. doi: 10.1016/j.vas.2021.100190. PMID: 34296043; PMCID: PMC8281653.


Other Uses

Uses & Benefits: bees, birds, butterflies, cosmetics, food, medicine, pot plant, small garden, water-wise, wind tolerant

The flowers contain nectar, attracting many birds, especially sunbirds, and insects as pollinators.

• Cosmetics
• Tonic drinks
• Mosquito repellent and insecticide.41,42
• Skin lightening

Use as Food

Plant Parts Used

Leaf gel
Flowers

Preparations

Tonic drinks
Marmalade
Tonics

 


Cultivation & Harvest

Light-level: full sun, semi-shade
Soil type: sandy, well-drained
Soil pH: 
Propagation: cuttings, seed

Aloes grow well in wide variety of habitats, from rocky hill slopes to semi-deserts to the Cape’s fynbos region. They like full sun, well-drained compost-enriched sandy soil. Aloes can be propagated from seeds and cuttings, but be careful to not over water cuttings, as this may cause them to rot. Aloes also hybridise easily with other aloes flowering at the same time.

Cultivation & Harvest
• Aloes grows well in wide variety of habitats, from rocky hill slopes to semi-deserts.
• Soil – well-drained compost-enriched sandy soil
• Light – full sun
Propagation
• Seeds
• Cuttings – do not overwater cuttings, may cause them to rot.
• Aloes hybridise easily with other aloes flowering at the same time.
Harvest
• Aloe ferox leaves provide an insulating layer to protect against fires, and harvesting of leaves could result in significant mortality in fires.13


Resources

Websites